Evidence-based policy and technological innovation

What is it about?

The study examines the dynamics through which policymakers can govern technological innovation in health through 'evidence'. The empirical context is the diffusion of a complex, expensive and visible technological innovation, the Da Vinci robot, within the Italian health care system. A multiple-case design based on over 140 in-depth interviews and documentary analysis led to the elaboration of four archetypes for governing through evidence, the common mechanisms of which are systematized in an emerging theory.

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Why is it important?

The evidence-based paradigm is increasingly permeating the spheres of policymaking and management in health care, as it has in most other public domains. An emerging stream of research has investigated how different institutional arrangements are more (or less) conducive to an effective evidence-based policy. The framework developed here contributes to this stream by suggesting that 'governing through evidence' entails selecting or combining a variety of evidentiary bases, structuring a new relational arrangement among the actors involved, and standardizing decisional criteria and procedures. Combining these elements with the specific governing output sought by policymakers explains the different steering capabilities of institutional arrangements in practice.